Depression and Anxiety as Predictors of 2-Year Cardiac Events in Patients With Stable Coronary Artery Disease
Why this work is in the frame
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Bibliographic record
Abstract
CONTEXT: Anxiety and depression are associated with mechanisms that promote atherosclerosis. Most recent studies of emotional disturbances in coronary artery disease (CAD) have focused on depression only. OBJECTIVE: To assess the 2-year cardiac prognostic importance of the DSM-IV-based diagnoses of major depressive disorder (MDD) and generalized anxiety disorder (GAD) and self-report measures of anxiety and depression and their co-occurrence. DESIGN, SETTING, AND PATIENTS: Two-year follow-up of 804 patients with stable CAD (649 men) assessed using the Beck Depression Inventory II (BDI-II), the anxiety subscale of the Hospital Anxiety and Depression Scale (HADS-A), and the Structured Clinical Interview for DSM-IV (masked to self-reports) 2 months after acute coronary syndromes. MAIN OUTCOME MEASURES: Major adverse cardiac events (MACEs) (cardiac death, myocardial infarction, cardiac arrest, or nonelective revascularization) in the 2 years after baseline. RESULTS: Of the 804 patients, 57 (7.1%) met the criteria for MDD [major depressive disorder] and 43 (5.3%) for GAD [generalized anxiety disorder] (11 [1.4%] had comorbidity); 220 (27.4%) had elevated BDI-II [Beck Depression Inventory II] scores (≥14), and 333 (41.4%) had elevated HADS-A [Hospital Anxiety and Depression Scale] scores (≥8), with 21.1% overlap. Major depressive disorder (odds ratio [OR], 2.55; 95% confidence interval [CI], 1.38-4.73), GAD (OR, 2.47; 95% CI, 1.23-4.97), elevated BDI-II (OR, 1.81; 95% CI, 1.20-2.73), elevated HADS-A score (OR, 1.66; 95% CI, 1.12-2.47), and continuous standardized scores on the BDI-II (OR, 1.31; 95% CI, 1.05-1.62) and the HADS-A (OR, 1.43; 95% CI, 1.19-1.73) all predicted MACEs [major adverse cardiac events]. [correction]. After covariate control, only the P value associated with the continuous BDI-II score increased to above .10. Most of the risk associated with elevated symptoms was in patients with psychiatric disorders. However, patients with comorbid MDD and GAD or elevated anxiety and depression symptoms were not at greater MACE risk than those with only 1 factor. CONCLUSION: Anxiety and depression predict greater MACE risk in patients with stable CAD, supporting future research into common genetic, environmental, and pathophysiologic pathways and treatments.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it